Substantive fee schedule discussion/Procedural analysis

Gentle Acupuncture, P.C. v Tri-State Consumer Ins. Co., 2017 NY Slip Op 50706(U)(App. Term 2d Dept. 2017)

(1) “With respect to the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that the amounts sought were not in accordance with the workers’ compensation fee schedule, we find that defendant did not establish its prima facie entitlement to summary judgment, as it failed to provide an expert’s affidavit to explain its interpretation of the fee schedule at issue”

** this was clearly an issue of  “additional bonus codes” that were by report or where the carrier sough to change the billed for code.  It does not involved 97810, 97811, 97813, 97814 or modality codes with RVUs compensated at the Chiropractor rate **

(2) “We note that, contrary to defendant’s argument, the omission of the jurat in Dr. Vatelman’s affirmation is not fatal (People ex rel. 5th Ave. & 37th St. Corp. v Miller, 261 App Div 550, 552 [1941], affd 286 NY 628 [1941]; see also People v Gouiran, 192 AD2d 620 [1993]), particularly in the absence of a showing of substantial prejudice to defendant (see CPLR 2001).”

** People ex rel. Fifth Ave. & 37th St. Corp. v. Miller, 261 App. Div. 550, 553 (1st Dept. 1941), aff’d, 286 N.Y. 628 (1941)

‘The courts are not entirely agreed as to the effect of the omission of a jurat or a signature thereto upon the affidavit. According to the majority view, such an omission is not fatal to the validity of the affidavit, so long as it appears, either from the rest of the instrument or from evidence aliunde, that the affidavit was, in fact, duly sworn to before an authorized officer. This rule is based upon the principle that a party should not suffer by reason of the inadvertent omission of the officer to perform his duty. Under this view, an affidavit defective by reason of the omission of the jurat of the officer’s signature may, upon proof of its authenticity, be cured by amendment
**

Mailing affidavit is wrong

Greenway Med. Supply Corp. v ELRAC, Inc., 2016 NY Slip Op 51774(U)(App. Term 2d Dept. 2016)

“Furthermore, while plaintiff argues on appeal that its employee’s affidavit, which was submitted in opposition to plaintiff’s motion, was sufficient to establish that plaintiff had mailed its claim form within 45 days of the provision of the supplies, the affidavit has no probative value. The claim form was dated July 1, 2010 and the affidavit states, allegedly based upon the affiant’s personal knowledge, that the claim form was mailed on June 23, 2010.

Mr. Greenway seems to have lost track of time.

 

Putting the cart before the horse?

New Way Acupuncture, P.C. v New York Cent. Mut. Fire Ins. Co., 2016 NY Slip Op 51527(U)(App. Term 2d Dept, 2016)

“Defendant’s motion was properly denied, as defendant failed to establish, as a matter of law, that plaintiff’s assignor had failed to appear for duly scheduled independent medical examinations. Among other things, the affidavit attesting to the second failure to appear indicates, on its face, that it had been notarized before it was signed (see e.g. 97 NY Jur 2d, Summary Judgment, Etc. § 47 [proof in support of summary judgment must be in evidentiary form]).”

This is an interesting one.  The notarization occurred before the signature?  I am guessing the affiant’s signature was an original and the notary signature was a photocopy?  How was this determined?

An interesting credit card case

Citibank (South Dakota), N.A. v Abraham, 2016 NY Slip Op 03133 (2d Dept. 2016)

The usual credit card non-payment case is straightforward.  This one is not, and could give us attorneys that defend credit card defendants some wiggle room.

This is the case where the credit card issuer lowers the credit limit, the client does not adjust his minimum payment due and the promotional rate moves northward to 29.99%.  The Court found the breach of contract absent the cardholder agreement not to be proved.

The account statement was not granted due to the failure to show an absence of protest.  The court also found that a minimal payment in relation to the minimum due on account did not express an assent.  This is an interesting case.

Later conflicting statements are “feigned” issues of fact

Mirjani v DeVito, 2016 NY Slip Op 00448 (1st Dept. 2016)

“It is axiomatic that statements made by a party in an affidavit, a police report, or a deposition that are not denied by the party constitute an admission, and that later, conflicting statements containing a different version of the facts are insufficient to defeat summary judgment, as the later version presents only a feigned issue of fact

Defective notarization

Clarke v Scottsdale Ins. Co., 2014 NY Slip Op 51586(U)(App. Term 2d Dept. 2014)

(1) 2309 defect does not matter anymore.  “While plaintiff timely objected to the form of defendant’s affidavit, in that it did not comply with the requirements of CPLR 2309 (c), the absence of a certificate of conformity is not a fatal defect”

(2)”Nevertheless, we find that the affidavit of defendant’s claims analyst was not in proper admissible form for a different reason, to wit, that the notary public never stated therein that the claims analyst had personally appeared before her and was personally known to her or had satisfactorily established her identity (see Galetta v Galetta, 21 NY3d 186 [2013]; see also Fryer v Rockefeller, 63 NY 268 [1875]; Gross v Rowley, 147 App Div 529 [1911]; cf. Collins v AA Truck Renting Corp., 209 AD2d 363 [1994]). “

Notorial acts.

Bonavera Acupuncture, P.C. v GEICO Indem. Co, 2013 NY Slip Op 50200(U)(App. Term 2d Dept. 2013)

“The affidavit recited that the affiant was “duly [*2]sworn . . . under an awareness of the penalties of perjury” and stated that the affidavit was “sworn to before” the notary, who signed and stamped the document..  The law does not require that a document drafted on one date be signed and notarized on that date. Accordingly, on the record presented, we find that the affidavit was in admissible form and should have been considered by the Civil Court”

The world of notarial acts.  It was sworn to and executed on a day different than when it was drafted.  This is sufficient under the law.

Electronic signatures unconditionally accepted

Martin v Portexit Corp., 2012 NY Slip Op 05088 (1st Dept. 2012)

Interestingly, my view of the law when I handled Rogy v. Mercury became the law in the First Department.  Perhaps, this is more of an academic issue in light of the fact that most of these electronic signatures now contain the appropriate language stating that it was placed at the request of the signor.

Here are the highlights:

“State Technology Law § 304(2) provides that “unless specifically provided otherwise by law, an electronic signature may be used by a person in lieu of a signature affixed by hand. The use of an electronic signature shall have the same validity and effect as the use of a signature affixed by hand” (see Wen Zong Yu v Charles Schwab & Co., Inc., 34 Misc 3d 32 [2011]; People v Johnson, 31 Misc 3d 145[A][2011]; Alpha Capital Anstalt v Qtrax, Inc., 26 Misc 3d 1234[A][2010]). CPLR 2106, which provides for affirmations by attorneys, physicians, osteopaths and dentists does not specifically provide that an electronic signature may not be used and that the signature may only be affixed by hand.

In Naldi v Grunberg (80 AD3d 1,12 [2010], lv denied 16 NY3d 711 [2011]), we held that the Legislature “appear[s] to have chosen to incorporate the substantive terms of E-SIGN [Electronic Signatures in Global and National Commerce Act, 15 USC § 7001 et seq.] into New York state law.” Notably, E-SIGN provides that where a statute requires a signature to be notarized, acknowledged, verified, or made under oath, “that requirement is satisfied if the electronic signature of the person authorized to perform those acts, together with all other information required to be included . . . is attached to or logically associated with the signature or record” (15 USC § 7001[g]). In Naldi, we concluded that “E-SIGN’S requirement that an electronically memorialized and subscribed contract be given the same legal effect as a contract memorialized and subscribed on paper” is New York law. We therefore held that the terms “writing” and “subscribed” in General Obligations Law § 5-703 should be construed to include, respectively, electronic communications and signatures (80 AD3d at 12).

There is no sound reason to treat the term “subscribed” as used in CPLR 2106 any differently than it is used in the statute of frauds. The Second Department’s decision in Vista Surgical Supplies, Inc. v Travelers Ins. Co. (50 AD3d 778 [2008]), upon which the motion court relied in concluding that the doctors’ reports were inadmissible, is unpersuasive, and we decline [*3]to follow it. In that case, the Court held that the reports containing the computerized, affixed or stamped facsimiles of the physician’s signature failed to comply with CPLR 2106 in that there was no indication as to who placed them on the reports, or any indicia that the signatures were authorized (see also Rogy Med. P.C. v Mercury Cas. Co., 23 Misc 3d 132[A][2009]). However, requiring such additional information imports a requirement not contemplated or included in either E-SIGN’s provision for signatures made under oath (see 15 USC § 7001[g]), or State Technology Law § 304(2)[FN1]. Additionally, State Technology Law § 306 provides that in any legal proceeding where the CPLR applies, an electronic record or signature may be admitted into evidence pursuant to article 45 of the CPLR. Based upon the foregoing, we conclude that the electronic signatures complied with CPLR 2106, that the affirmations of defendants’ medical experts were admissible and that the affirmations should have been considered by the motion court.”

Mr. Five Boro finally squeaks one out

Five Boro Psychological Servs., P.C. v GEICO Gen. Ins. Co., 2012 NY Slip Op 51057(U)(App. Term 2d Dept. 2012)

He is a rambunctious soul.  They say he is devoted to performing a never ending battery of Beck Inventory Tests and has a mobile Scantron reader because the patients need results.  Instant gratification is how business is performed nowadays.  His patients need physical therapy and are engaged with his form of therapy.  The Appellate Term generally disfavors him, but he beat back Geico.  Fear not, it was not on the merits.  Mr. Five Boro took a page out of Mercury’s 2010 play book.  He figured it worked then; why should it not work now?

“Plaintiff argues on appeal, as it did in the Civil Court, that the peer review reports defendant submitted in support of its cross motion for summary judgment were not in admissible form. We agree, as the peer review reports were affirmed by a psychologist, which is not permissible pursuant to CPLR 2106 (see Eagle Surgical Supply, Inc. v Progressive Cas. Ins. Co., 34 Misc 3d 145[A], 2012 NY Slip Op 50151[U] [App Term, 2d, 11th & 13th Jud Dists 2012]; High Quality Med., P.C. v. Mercury Ins. Co., 29 Misc 3d 132[A], 2010 NY Slip Op 51900[U] [App Term, 2d, 11th & 13th Jud Dists 2010]). We note that, although one of the peer review reports contained a notary public’s stamp and signature, it did not include an attestation that the psychologist had appeared before the notary public and been duly sworn”

I tip my hat to Mr. Five Boro on this one.

Peer hearsay and electronic signatures

Alfa Med. Supplies v GEICO Gen. Ins. Co., 2012 NY Slip Op 50934(U)(App. Term 2d Dept. 2012)

Contrary to plaintiff’s argument on appeal, defendant was not required to annex to its motion papers copies of the medical records which had been reviewed by defendant’s peer [*2]reviewer (see Elmont Open MRI & Diagnostic Radiology, P.C. v New York Cent. Mut. Fire Ins. Co., 30 Misc 3d 126[A], 2010 NY Slip Op 52222[U] [App Term, 9th & 10th Jud Dists 2010]; Urban Radiology, P.C. v Tri-State Consumer Ins. Co., 27 Misc 3d 140[A], 2010 NY Slip Op 50987[U] [App Term, 2d, 11th & 13th Jud Dists 2010]). Furthermore, while plaintiff argues that the peer review report contained an electronic stamped facsimile of the peer reviewer’s signature and, as a result, the report was inadmissible, the record indicates that the facsimile signature was permissibly placed on the report by the chiropractor who had performed the peer review (see Quality Health Prods. v Geico Gen. Ins. Co., 34 Misc 3d 129[A], 2011 NY Slip Op 52299[U] [App Term, 2d, 11th & 13th Jud Dists 2011]; Eden Med., P.C. v Eveready Ins. Co., 26 Misc 3d 140[A], 2010 NY Slip Op 50265[U] [App Term, 2d, 11th & 13th Jud Dists 2010]).

Nothing new to report.